Helsana Grundversicherung
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Standard model
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Free choice of doctor
General
General information:
Health insurance model «Grundversicherung» of the Swiss insurance company Helsana.
Health insurance model:
Standard model: You can make use of any doctor, specialist or other healthcare service provider you choose. Premiums are higher than those of more limited models.
Choice of doctor:
Policyholders have free choice of doctors.
Medical partner:
Not specified.
Pharmacy choice:
You get free choice of pharmacy
Payment methods:
18% of payments are made using the tiers garant payment method, in which you pay and claim reimbursement.
82% of payments are tiers payant, meaning the bills are paid directly by the insurance (Helsana).
82% of payments are tiers payant, meaning the bills are paid directly by the insurance (Helsana).
Reimbursement:
The average waiting period before tiers garant reimbursement from Helsana is 9 days.
Financial reserves:
The solvency ratio shows how available financial reserves compare to Federal Office of Public Health (FOPH) minimum reserve requirements. The solvency ratio of Helsana is 130% (according to FOPH data). The minimum ratio required by the FOPH is 100%.
Number of policyholders:
A total of 1,412,757 people hold compulsory health insurance policies from Helsana.
Additional child-discount:
Helsana provides additional premium reductions from the third child onwards.
Bonus insurance:
Helsana Grundversicherung lets you choose claim-free discounts as an option with its compulsory health insurance policies. A 10% markup on premiums applies during your first year as a policyholder, while a discount is applied every subsequent year during which you do not make any insurance claims.
Administrative costs:
4.5% (ratio of adminstrative costs to risk-adjusted premiums as per BAG data).
Administrative costs per policyholder:
CHF 171 (as per the most recent BAG data).
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